Obesity in children is one of the fastest-growing challenges that parents and pediatricians are facing alike. A staggering 390 million children and adolescents aged 5–19 years were overweight in 2022, including 160 million who were living with obesity. It is not just limited to children over the age of 5; 37 million children under the age of 5 were overweight. Overweight and obesity in childhood increase the risk of many lifestyle diseases like Type 2 diabetes and cardiovascular diseases in adulthood.
Obesity and overweight are estimated on the basis of Body Mass Index (BMI). A BMI of more than 23 kg/m² is said to be overweight and more than 27 kg/m² is said to be obese. Almost 98% of children with obesity do not have any underlying illness. It arises from a sedentary lifestyle and poor dietary choices.
Managing and treating obesity is a challenging task for both parents and children. As the old adage says, ‘prevention is better than cure’; there are small modifications that can be done in our lifestyle that can prevent this chronic condition from hampering a child’s happiness.
Exclusive breastfeeding till 6 months of age has been seen to reduce the chances of obesity. Children should have regular meal timings, including breakfast. They should have at least 8 hours of sleep daily at night. The American Academy of Pediatrics recommends fighting childhood obesity with the ‘5-2-1-0’ rule. It implies children can consume above 5 servings of fruits and vegetables, screen time below 2 hours, participate in one hour of physical activity, and consume 0 sugar-sweetened beverages daily.
Healthy eating behaviours should be developed in children from the start. The satiety centre, or the centre that signals the brain that hunger is over, doesn’t work when a child consumes food in front of the TV or mobile. Hence, eating meals with a screen ‘on’ should be stopped. Junk food in the home should be replaced with fruits, and sugary drinks should be replaced with drinking water. Children copy parents in every act, including this one. So parents should start with these habits themselves, which will leave a long-lasting impact on children.
Once diagnosed with obesity, management should start with lifestyle and dietary modifications. Children should consume regular meals. Breakfast should not be skipped. He/she should have 45 minutes of regular moderate to vigorous physical activity and screen time should be below 1 hour daily. Teenagers are more prone to being body conscious and might face body shaming in the current online world. They should never go for crash dieting or starvation. It could do a lot more harm than being beneficial. Parents should be on the lookout for red flag signs like sudden weight gain, delayed growth and puberty, school absenteeism or teasing by peers regarding weight/appearance, persistent anxiety, depression, or self-harm, anger outbursts, substance abuse and eating disorders. Specialist referral must be sought after in the presence of these signs.
Remember, obesity runs in families who do not run. Getting obesity under control not only improves health; it also gives a feeling of achievement and happiness.
(The author, Dr. Anand Narayanan, is an associate consultant – pediatrics, in Sarvodaya Hospital.)
